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Covax misses its 2021 delivery target – what’s gone wrong in the fight against vaccine nationalism?

A shipment of Covax doses arrive from the US in Timor L'este. Antonio Dasiparu/EPA-EFE

Covax misses its 2021 delivery target – what’s gone wrong in the fight against vaccine nationalism?

A shipment of Covax doses arrive from the US in Timor L'este. Antonio Dasiparu/EPA-EFE

Covax misses its 2021 delivery target – what’s gone wrong in the fight against vaccine nationalism?

A shipment of Covax doses arrive from the US in Timor L'este. Antonio Dasiparu/EPA-EFE

Covax misses its 2021 delivery target – what’s gone wrong in the fight against vaccine nationalism?

A shipment of Covax doses arrive from the US in Timor L'este. Antonio Dasiparu/EPA-EFE

Covax misses its 2021 delivery target – what’s gone wrong in the fight against vaccine nationalism?

Rory Horner, University of Manchester

The latest supply forecast for Covax – the programme for sharing COVID-19 vaccines around the world – suggests that accelerating vaccination in low-income countries looks unlikely. Covax estimates it will have distributed 1.425 billion vaccine doses by the end of 2021, significantly less than the 2 billion doses it was aiming for earlier this year.

Only 280.5 million COVID-19 vaccine doses have been given out through Covax as of September 15 2021. With some high-income countries rolling out boosters and vaccinating children before many low-income countries have even given their adults a first dose, vaccine inequality is showing no sign of disappearing.

That Covax has fallen short on its initial forecast for 2021 is not a surprise. The CEO of the Serum Institute of India, originally the largest intended supplier to the initiative, cast doubt on the 2 billion figure soon after its release, suggesting that reaching this milestone would take an additional six months.

A major problem has been getting a good place in the vaccine queue. While Covax was raising money following its launch in June 2020, many high-income countries were already buying up much of the initial supply from manufacturers. Dr Tedros Adhanom Ghebreyesus, director-general of the World Health Organization (WHO), argues that despite providing it with financial support, the world’s biggest economies have thus undermined Covax.

However, the biggest setback was in late March, when exports of COVID-19 vaccines from India – the world’s biggest COVID-19 vaccine manufacturer – were suspended. India’s output was redirected to domestic supply in light of the country’s devastating second wave. The Serum Institute of India had been due to supply Covax with over a billion doses in 2021. Currently exports have still not resumed, with the country having exported only 20 million doses to Covax.

Low-income countries, the main target for the programme, remain drastically behind on COVID-19 vaccination as a result. On average three COVID-19 vaccine doses have been administered per 100 people in low-income countries, compared to more than 120 in high-income countries.

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